In genetic association analysis, a joint test of multiple distinct phenotypes can increase power to identify sets of trait-associated variants within genes or regions of interest. Existing multi-phenotype tests for rare variants make specific assumptions about the patterns of association of underlying causal variants, and the violation of these assumptions can reduce power to detect association. Here we develop a general framework for testing pleiotropic effects of rare variants based on multivariate kernel regression (Multi-SKAT). Multi-SKAT models effect sizes of variants on the phenotypes through a kernel matrix and performs a variance component test of association. We show that many existing tests are equivalent to specific choices of kernel matrices with the Multi-SKAT framework. To increase power to detect association across tests with different kernel matrices, we developed a fast and accurate approximation of the significance of the minimum observed p-value across tests. To account for related individuals, our framework uses a random effects for the kinship matrix. Using simulated data and amino acid and exome-array data from the METSIM study, we show that Multi-SKAT can improve power over single-phenotype SKAT-O test and existing multiple phenotype tests, while maintaining type I error rate.
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